Individual provider Active NPI

Kiley Ethridge

  • Physical Therapist
  • Pensacola, FL
National Provider Identifier
1922964345
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT44201 Issued in FL
Practice address
7830 Pine Forest Rd
Pensacola, FL 32526-8404
Phone
(850) 941-5000
NPI assigned
Dec 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT9469 AL
Physical Therapist 225100000X PT44201 FL Primary

Addresses

Primary practice location

7830 Pine Forest Rd
Pensacola, FL 32526-8404

Mailing address

21 Caisson Trce
Spanish Fort, AL 36527-3101
Phone (334) 726-4547

Other practice location 1

2310 Abbie Ln
Pensacola, FL 32514-5983
Phone (850) 505-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227000148 FL Practitioner - Physical Therapist in Private Practice 5092296079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of South Alabama College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

7830 Pine Forest Rd
BLDG a
Pensacola, FL 32526-8782
Phone (850) 741-6715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT9469ALMDPhysical Therapist
PT44201FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Action Therapy Group LLC Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients

Locations

3964 Florida Ave
Jay, FL 32565
Phone (850) 675-4000

7830 Pine Forest Rd
Bldg A
Pensacola, FL 32526

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1767052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1922964345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CAISSON TRCE",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365273101",
            "telephone_number": "334-726-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 PINE FOREST RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325268404",
            "telephone_number": "850-941-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2310 Abbie Ln",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325145983",
            "country_code": "US",
            "telephone_number": "850-505-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "KILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PT9469",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT44201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.